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Department of the Treasury — Internal Revenue Service
13013
Taxpayer Advocacy Panel (TAP)
(Revised March 2012)
OMB No. 1545-1788
Membership Application
Part I a – Personal Information
Last name
First name
Middle initial
Home address (street address preferred)
City
County
State
Legal resident of which US State
Email address
Home phone number (include area code)
Cellular phone number (include area code)
ZIP Code
Business phone number (include area code)
Employment Status
Currently Employed
Retired (indicate former Employer and Position/Occupation, below)
Other (indicate under Position/Occupation)
Employer
Position held / Occupation
How did you hear about the IRS Taxpayer Advocacy Panel
Tell us why you want to be a member of the IRS Taxpayer Advocacy Panel
All information provided on this form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.org
Catalog Number 31517Y
www.irs.gov
Form
13013
(Rev. 3-2012)
Page 2 of 4
Part I b – Panel Membership Requirements
(Note: Current IRS or Treasury Department employees or former employees who worked for the IRS or the Treasury Department
during the last three years are not eligible to serve on the Taxpayer Advocacy Panel).
Yes
No
1. Are you a current IRS or Treasury employee
2. Are you a former IRS or Treasury employee who last worked for the IRS or Treasury within three
years from December 1st of the current year
3. Are you a United States citizen
4. Are you willing to travel overnight to attend multi-day meetings/events (Note: Panel
members will be reimbursed by the IRS for authorized travel expenses.)
5. Are you willing to serve as a volunteer Panel member for 3 years
6. Are you willing and able to commit approximately 300-500 hours of volunteer service to the
Taxpayer Advocacy Panel each year
7. Are you willing to have the IRS check to make sure you are current with your Federal tax filings
and financial obligations
8. Are you willing to undergo an FBI background check
9. Are you an agent for another country who is registered or required to register under the Foreign
Agent Registration Act
10. Are you a federally-registered lobbyist or a lobbyist for a foreign entity who is registered or required
to register under the Lobbying Disclosure Act of 1995
Part II – Demographic Information
Note: You are not required to provide demographic information. However, if you choose to provide the information, it will help to
ensure that the panel membership reflects the diversity and representation of the overall population.
Ethnicity (check one)
Gender (check one)
Male
Female
Hispanic or Latino
Not Hispanic or Latino
What is your race (check all that apply)
White
Native American or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
Other (Specify):
Language – Can you read, write or speak any the following languages (check all that apply)
English
Chinese
Korean
Spanish
Vietnamese
Russian
Other (Specify):
Age (check one)
18-29 years
40-49 years
60-69 years
30-39 years
50-59 years
70-years and older
$24,999 or less a year
$35,000 - $49,999
$75,000 - $99,999
$25,000 - $34,999
$50,000 - $74,999
$100,000 or more
Household Income / Salary (check one)
All information provided on this form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.org
Catalog Number 31517Y
www.irs.gov
Form
13013
(Rev. 3-2012)
Page 3 of 4
Part III – Experience
TAP Members are a diverse group of citizens who work on committees to improve the Federal tax administration system. Answer each
question below in sufficient detail to enable us to assess your experience. Your experience can be both personal and professional. This
information is used to determine your qualifications to be a productive member of the TAP. (If completing this form electronically, type
your response under each question. If completing by hand, attach additional sheets with your responses.)
1. As a member of the Taxpayer Advocacy Panel you will be assigned to committees responsible for preparing recommendations and
proposals to the IRS. Provide one or more detailed examples of your experience working as a member of a group. Describe the
group's task, your role in the group, and the outcome of the task.
2. As a member of the Taxpayer Advocacy Panel you will be expected to speak with individuals and groups about the Panel and use
the opportunity to get ideas and suggestions for improving IRS customer service and satisfaction. Provide one or more detailed
examples of your experience speaking to individuals or groups to communicate information about a program or initiative.
3. As a member of the Taxpayer Advocacy Panel you will present recommendations/proposals from the public to other committee
members. Provide one or more detailed examples of your experience presenting a position on a particular issue.
4. As a member of the Taxpayer Advocacy Panel you may have to present a position that you do not agree with. Provide one or more
detailed examples of your experience presenting a position you do not agree with or describe how you might handle this situation.
5. As a member of the Taxpayer Advocacy Panel you will work on problems and develop solutions to address these problems. Provide
one or more detailed examples of problems you worked on and what steps you took to resolve the problem.
6.
Provide one or more detailed examples of committees, organizations and groups (both personally and professionally) that you have
been involved in that demonstrate your commitment to volunteerism. Include the specific contributions you made.
All information provided on this form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.org
Catalog Number 31517Y
www.irs.gov
Form
13013
(Rev. 3-2012)
Page 4 of 4
Part III – Experience (Continued)
TAP Members are a diverse group of citizens who work on committees to improve the Federal tax administration system. Address
each question below in sufficient detail to enable us to assess your experience. Your experience can be both personal and
professional. This information is used to determine your qualifications to be a productive member of the TAP.
Are you currently a tax practitioner in any of the following categories (check all that apply)
Certified Public Accountant (CPA)
Enrolled Agent
Tax Attorney
Paid Tax Return Preparer
Computer Skills (check all that apply)
TAP members are geographically dispersed across the nation so they must rely on current technology to communicate and work on
projects from remote locations. Please indicate your proficiency using the technology below.
Unrestricted access to a computer
and ability to navigate the Internet
Ability to send and receive e-mail
with attached documents
Experience using software for creating
or reviewing documents
Part IV – Certification (You must sign your application to have it considered valid )
I certify that I am a legal resident of the United States of America; I have fulfilled my tax obligations; I have not been involved in criminal
activities; and, to the best of my knowledge and belief, all of my statements herein are true, correct, complete, and made in good faith.
Signature of Applicant
Date
Applicants are encouraged to apply electronically from the IRS TAP website at: www.improveirs.org. Please complete and
submit this application, only if you are unable to electronically apply from the IRS TAP web site.
Mail this paper application to:
IRS TAP Office
Room 1509
1111 Constitution Avenue
Washington, DC 20224
You may also FAX the application to: 1-202-622-9382
Use your smartphone to scan this barcode. You will be directed to the Taxpayer Advocacy Panel’s
public website at www.improveirs.org where more information about the Taxpayer Advocacy Panel
can be found.
To scan a QR code, users must have a smartphone with a software application which can scan and
decode a QR code.
Paperwork Reduction Act Notice
We ask for information on this form to carry out the Internal Revenue laws of the United States. Your response is voluntary. You are not required to
provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal
Revenue law. Generally, tax returns and information are confidential, as required by Code section 6103.
The time needed to complete this form will vary depending on the individual circumstances. The estimated average time is 90 minutes.
If you have comments concerning the accuracy of this time estimate or suggestions for making this form simpler, please submit your comments in writing
to: Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave., NW, Washington, DC 20224. Do
not mail your Application to this address.
All information provided on this form will remain Confidential.
If you have questions, please call: 1-888-912-1227, or visit our website at: www.improveirs.org
Catalog Number 31517Y
www.irs.gov
Form
13013
(Rev. 3-2012)
File Type | application/pdf |
File Title | Form 13013 (Rev. 3-2012) |
Subject | Taxpayer Advocacy Panel (TAP) Membership Application |
Author | TA:TAP |
File Modified | 2012-04-02 |
File Created | 2012-03-13 |